HOUSING CONCERNS AND TRAJECTORIES OF KINLESS OLDER ADULTS WITH DEMENTIA

Abstract Housing preferences of older adults (e.g., to remain in residence, or relocate), housing options available, and housing needs related to changing physical and cognitive abilities are common concerns of aging. The challenges are possibly more complex for those living with dementia, who may have difficulty articulating housing preferences, and whose housing needs may include supportive care. For those with dementia who lack close kin, these challenges are likely significantly compounded. This paper focuses on the intersection of housing concerns for 64 participants in the Adult Changes in Thought (ACT) study who were kinless (no living spouse or children) when they developed dementia. All the ACT participants were 65+ when recruited. Everyone in this sample had received a research diagnosis, and their mean age at dementia onset (estimated at the midpoint between the research study that triggered the diagnostic evaluation, and the last research study before that -- usually one year before diagnosis) was 87 (Standard Deviation [SD] 7 years), with a median age of 86 and a range of 71-103.We present an analysis of their housing trajectories, as captured in chart notes from their medical records. We highlight multiple themes illustrating how housing intersects with health and social well-being and conclude by commenting on the potential of medical records for understanding and documenting issues related to housing.

among older adults while maintaining community mobility.The team of 13 international researchers from seven countries used the Covidence software with support of an expert health sciences librarian.Using multiple search terms (e.g., driving retirement; driving cessation; driving transition; interventions; strategies; older adults), 7317 studies were imported for screening with 7059 eliminated; 205 full texts were assessed for eligibility by 2-3 members.With 187 excluded, 19 studies were included and examined by the two primary authors.Results demonstrate low evidence of effectiveness of programmatic interventions, although multiple strategies have been identified.Overwhelmingly, the evidence supports starting very early with discussions about the process of transitioning from driving to being a passenger; particularly true with progressive diagnoses such as dementia.This presentation will highlight the programs currently available, strategies that appear to be successful, and review current toolkits for supporting driving cessation as well as emerging interventions and strategies.Dementia is rising in the global population, especially in low-and middle-income countries like India.Hearing and vision loss are risk factors for cognitive decline/dementia, but studies have primarily been in high income countries.This study aims to investigate the association between dual sensory loss and cognitive function with specific domains among the older Indian population.Data was from the 2017-2019 Wave 1 of the population-based Longitudinal Aging Study in India.The analysis sample consists of 27,975 individuals aged 60 years and older in 35 states and union territories.Dual sensory loss was determined by respondents' self-reported, perceived difficulty regarding hearing and vision function.Linear regression was used to model associations of dual sensory loss with global cognitive performance, summarized as a z-score, and in the domains of memory, orientation, arithmetic, and executive function, adjusted for demographics and health characteristics.Overall, 5.9% had hearing loss, 24.1% had vision loss, and 3.4% had both.In fully adjusted models, hearing loss only, vision loss only, and dual sensory loss were associated with a change of -0.08 (95%CI: -0.1, -0.04), -0.11 (95%CI: -0.12, -0.09), and -0.22 (95%CI: -0.27, -0.18) standard deviations, respectively.Associations were also observed for all domains.Poor hearing and/or vision loss is associated with lower cognitive performance across various cognitive domains in older adults in India.The association was strongest for those with dual sensory loss.Rehabilitative interventions for hearing and vision may be an additional resource in reducing dementia risk in India.

HOUSING CONCERNS AND TRAJECTORIES OF KINLESS OLDER ADULTS WITH DEMENTIA
Tam Perry 1 , Janelle Taylor 2 , and Yasir Mehmood 1 , 1. Wayne State University, Detroit, Michigan, United States, 2. University of Toronto, Toronto, Ontario, Canada Housing preferences of older adults (e.g., to remain in residence, or relocate), housing options available, and housing needs related to changing physical and cognitive abilities are common concerns of aging.The challenges are possibly more complex for those living with dementia, who may have difficulty articulating housing preferences, and whose housing needs may include supportive care.For those with dementia who lack close kin, these challenges are likely significantly compounded.This paper focuses on the intersection of housing concerns for 64 participants in the Adult Changes in Thought (ACT) study who were kinless (no living spouse or children) when they developed dementia.All the ACT participants were 65+ when recruited.Everyone in this sample had received a research diagnosis, and their mean age at dementia onset (estimated at the midpoint between the research study that triggered the diagnostic evaluation, and the last research study before that --usually one year before diagnosis) was 87 (Standard Deviation [SD] 7 years), with a median age of 86 and a range of 71-103.We present an analysis of their housing trajectories, as captured in chart notes from their medical records.We highlight multiple themes illustrating how housing intersects with health and social well-being and conclude by commenting on the potential of medical records for understanding and documenting issues related to housing.

INCLUDING PEOPLE WITH COGNITIVE IMPAIRMENT IN HEALTH SERVICES RESEARCH: PROMISING PRACTICES AND LESSONS LEARNED Alice Prendergast Boughrum, and Kristi Fuller, Georgia State University, Atlanta, Georgia, United States
Engaging impacted populations, including consumers, in the design of health policies and services is increasingly recognized and prioritized in the United States.However, people with dementia and other forms of cognitive impairment are underrepresented and have often been excluded from health services research.As the number of people worldwide who are living with some form of cognitive impairment is expected to rise dramatically in the coming years, it is critical that researchers across all areas of health services research consider including this population in their work and ensure decisions for exclusion are fully justified.That said, individuals with cognitive impairment constitute a vulnerable population and additional precautions and safeguards are warranted to ensure they are protected throughout and beyond their participation in research studies.The inclusion of people with cognitive impairment also adds complexity to studies, and appropriate research protocols are often challenging to design and implement.This poster will describe two studies conducted by researchers at Georgia State University that included populations with cognitive impairment.The content will cover background about the study populations, which varied in diagnosis and disease progression; methods for recruitment, screening, and consent; and helpful communication strategies to employ throughout the research process.The poster will also share lessons learned and promising practices identified for both studies.

PREVALENCE OF DEMENTIA AND COGNITIVE IMPAIRMENT IN PUBLIC SENIOR HOUSINGS: A SYSTEMATIC REVIEW AND META-ANALYSIS
Soobin Park 1 , Takashi Amano 2 , Sojung Park 3 , and BoRin Kim 4 , 1. Washington University in St. Louis,St. Louis,Missouri,United States,2. Rutgers University,Newark,New Jersey,United States,3. Washington University in Saint Louis,St. Louis,Missouri,United States,4. University of New Hampshire,Durham,New Hampshire,United States Older residents in public housing represent a particularly vulnerable population at risk for cognitive decline due to their disadvantaged socioeconomic and health-related characteristics which are well-known risk factors of dementia.This study aims to synthesize available evidence regarding the prevalence of dementia and cognitive impairment among public senior housing residents.We conducted a literature search for studies published in English in the following databases: PsychInfo, PubMed, MEDLINE, CINAHL, and The Cochrane Library.We focused on observational studies about residents of public senior housings that reported prevalence and/or incidence of dementia and/or cognitive impairment screened by assessment tools for detecting dementia equivalent cognitive impairment.A total of ten studies were included for a meta-analysis to estimate the overall prevalence of cognitive impairment and dementia.Seven of ten studies utilized screening tools to detect dementia equivalent cognitive impairment.Overall pooled prevalence of cognitive impairment or dementia was 20.4% (95%CI: 14.1-27.5).The subgroup analyses revealed the pooled prevalence of cognitive impairment among residents of public senior housing was 25.5% (95%CI: 22.0-29.1)and pooled prevalence of dementia was 13.5% (95%CI: 8.3-19.7).The subgroup findings suggest the prevalence of dementia may be higher among residents of public senior housing compared to their peers in non-public housing.Also, this population may be particularly susceptible to an unrecognized or delayed diagnosis of dementia due to the lack of formal detection strategies in public senior housing.More resources should be allocated for detection to ensure better support the residents.

PROJECTION OF MEDICAID SPENDING ON PEOPLE WITH ALZHEIMER'S DISEASE AND OTHER RELATED DEMENTIAS Howard Degenholtz, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
As the US population is aging, the number of people with Alzheimer's Disease and Other Related Dementias (ADRD) is increasing.People with ADRD have high expenditures on medical care and long-term services and supports (LTSS).Medicaid is the largest single payor for LTSS, however, the literature on the demographic trends and epidemiology of people with ADRD does not offer projections of Medicaid spending.The goal of this study was to develop an estimate for future Medicaid spending for people with ADRD for the state of Pennsylvania.The approach taken was to develop a demographic projection of the size of the older population, then estimate the fraction of people with ADRD who